A recent research report by NUI Galway on improving the quality of life of older people in long-stay settings in Ireland calls for improvements in both practice and policy in the sector.

The study, which was funded and published by the National Council on Ageing and Older People, documents the experiences of residents, relatives and staff of public, private and voluntary long-stay facilities in Ireland. The research is the first comprehensive analysis of the factors influencing quality of life for older people in long-stay care in this country. Over 556 long-stay care facilities were surveyed and 101 older people and 48 staff were interviewed across 8 counties.

Dr Kathy Murphy, Head of Nursing Studies at NUI Galway, who led the research, commented, "The report can provide the basis for major changes in the regulation of public and private long-stay care in the future. Our growing population of older people deserve a good quality of life and we need to address the issues in long-stay care which are impacting negatively on this".

The results of the research suggest that there are four key domains which impact on a person's quality of life in long-stay care: 1. Physical environment and ethos of care. 2. The ability to maintain a sense of self and identity. 3. Meaningful activities. 4. Connectedness to family, friends and community.

Physical environment and ethos of care The research found that physical environment, which impacts quality of life by allowing older people to live their lives with dignity and privacy, was lagging behind in the public sector. Many of the long-stay care public facilities could not provide the residents with single or double rooms and many older people still lived in 6-8 bedded wards.

Differences in staffing levels and skill mix between public and private facilities were identified by the report, with public facilities having higher levels of registered nurses and higher staffing levels overall. The report showed that the ethos of care within residential care can help offset some of the negative effects of physical environment and staffing. According to Adeline Cooney, Deputy Head of the Department of Nursing, a member of the research team, "It is very simple. Where care is person-centred and homely, older people do better".

The ability to maintain a sense of self and identity The report found that older people wanted to maintain their individuality. Having some personal belongings, living in an environment in which they could have some privacy and being treated as an individual, rather than one of many, was important to them.

Meaningful activities Another finding of the report noted residents wanted meaningful activities and opportunities to maintain their independence. They would like to be consulted more on day to day life in the facility and want control over their day, including what time to get up or go to bed and mealtimes.

Connectedness to family, friends and community Older people also valued their connectedness to family and friends. Visits from family and friends are very important to older people. Regular visits helped to maintain family bonds and keep the older person in touch with what is happening at home and in the local community.

Recommendations The report made many recommendations including:

• Greater consultation with older people in long-stay care.
• Uniform national care standards.
• New investment in public long-stay facilities.
• Person-centred models of care.
• Enhanced training and education of staff in all types of long-stay care.

Professor Eamon O Shea, Director,Irish Centre for Social Gerontology NUI, Galway, who was part of the research team, commented that, "Older people in long-stay care are more than just patients, they are individuals who deserve to be treated with dignity and respect in an environment that is empowering, enabling and connected".